| NPI | 1114933967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0036169) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH 0036169) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-04-24 |